Collaco Joseph M, Aherrera Angela D, Breysse Patrick N, Winickoff Jonathan P, Klein Jonathan D, McGrath-Morrow Sharon A
Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins School of Medicine, and Julius B. Richmond FAMRI Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois; and
Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins School of Medicine, and.
Pediatrics. 2015 Mar;135(3):e678-86. doi: 10.1542/peds.2014-2501. Epub 2015 Feb 2.
Tobacco smoke exposure (TSE) may increase respiratory morbidities in young children with bronchopulmonary dysplasia (BPD). Rapid respiratory rates, close proximity to a smoking caregiver, and increased dermal absorption of tobacco smoke components can contribute to systemic exposure. In this study, hair nicotine levels were used as a biomarker of chronic TSE in young children with BPD to determine if hair nicotine levels correlate with caregiver self-report of TSE and respiratory morbidities.
From 2012 to 2014, hair nicotine levels were measured from consecutive children seen in a BPD outpatient clinic and compared with caregiver questionnaires on household smoking. The relationship between respiratory morbidities and self-reported TSE or hair nicotine level was assessed.
The mean hair nicotine level from 117 children was 3.1 ± 13.2 ng/mg. Hair nicotine levels were significantly higher in children from smoking households by caregiver self-report compared with caregivers who reported no smoking (8.2 ± 19.7 ng/mg vs 1.8 ± 10.7; P < .001). In households that reported smoking, hair nicotine levels were higher in children with a primary caregiver who smoked compared with a primary caregiver who did not smoke. Among children with BPD who required respiratory support (n = 50), a significant association was found between higher log hair nicotine levels and increased hospitalizations and limitation of activity.
Chronic TSE is common in children with BPD, with hair nicotine levels being more likely to detect TSE than caregiver self-report. Hair nicotine levels were also a better predictor of hospitalization and activity limitation in children with BPD who required respiratory support at outpatient presentation.
接触烟草烟雾（TSE）可能会增加患有支气管肺发育不良（BPD）的幼儿的呼吸道疾病发病率。呼吸频率快、与吸烟的照顾者近距离接触以及烟草烟雾成分经皮肤吸收增加，都可能导致全身暴露。在本研究中，头发中的尼古丁水平被用作患有BPD的幼儿慢性TSE的生物标志物，以确定头发中的尼古丁水平是否与照顾者关于TSE和呼吸道疾病的自我报告相关。
2012年至2014年，对在BPD门诊连续就诊的儿童测量头发中的尼古丁水平，并与关于家庭吸烟情况的照顾者问卷进行比较。评估呼吸道疾病与自我报告的TSE或头发尼古丁水平之间的关系。
117名儿童的头发尼古丁平均水平为3.1±13.2 ng/mg。根据照顾者的自我报告，来自吸烟家庭的儿童的头发尼古丁水平显著高于报告不吸烟的照顾者家庭的儿童（8.2±19.7 ng/mg对1.8±10.7；P<.001）。在报告有吸烟情况的家庭中，主要照顾者吸烟的儿童的头发尼古丁水平高于主要照顾者不吸烟的儿童。在需要呼吸支持的BPD儿童（n = 50）中，发现较高的头发尼古丁水平对数与住院次数增加和活动受限之间存在显著关联。
慢性TSE在患有BPD的儿童中很常见，头发尼古丁水平比照顾者的自我报告更有可能检测到TSE。头发尼古丁水平也是在门诊就诊时需要呼吸支持的BPD儿童住院和活动受限的更好预测指标。
